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• Proposes nationwide HIE to be managed by a single
Recognized Coordinating Entity (RCE)
– Participation is voluntary
– RCE to be chosen via competitive bidding, must have
history of “multi-stakeholder collaborations and
implementing governing principles”
– RCE will add provisions and technical requirements
(with ONC approval) to cover unaddressed policies
• TEFCA requires qualified entities (i.e. EHRs) to:
– …use a MPI, record locator, and query service
– …be participant neutral (not withhold data)
– …meet standard core data classes
• Recommends use of ISA standards: C-CDA, HL7 v2
messaging, FHIR
• Data Blocking – New rules Proposed this week!
CMS EHR Incentive Program:
Meaningful Use Stage 3 (MU3)
21
st
Century Cures Act:
Trusted Exchange Framework (TEFCA)
Source: Monica, K. (2018). APIs, TEFCA Expected to Boost EHR Interoperability Industry-Wide.
[online] EHRIntelligence. Available at: https://ehrintelligence.com/news/apis-tefca-expected-to-boost-
ehr-interoperability-industry-wide [Accessed 8 Feb. 2019].
“Any application chosen by a patient would enable
the patient to gain access to their individual health
information provided that the application is configured to
meet the technical specifications of the API.
Providers may not prohibit patients from using any
application, including third-party applications, which
meet the technical specifications of the API, including
the security requirements of the API.”
– Center for Medicare & Medicaid Services, “Medicaid EHR
Incentive Program Stage 3 - Patient Electronic Access to Health
Information”
Note: For 2019 and beyond, “MU3 – Patient Electronic Access to Health Information”
becomes “Promoting Interoperability Programs – Provider to Patient Exchange”